Asymptomatic Neurosyphilis in HIV infected patients at a Brazilian HIV and AIDS specialized service: a cross sectional study.

Cláudio Queniti Hirai,Danielle Cristina Tita Granzotto,Eniuce Menezes De Souza,Jorge Juarez Vieira Teixeira,Dennis Armando Bertolini,Deborah De Castro Moreira

doi:10.1590/0037-8682-0418-2021

Cláudio Queniti Hirai, Danielle Cristina Tita Granzotto + Show 4 more

Open Access

https://doi.org/10.1590/0037-8682-0418-2021

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Abstract

ABSTRACTBackground: Many human immunodeficiency virus (HIV) and syphilis co-infected patients are not diagnosed, which may evolve into asymptomatic neurosyphilis (ANS). We studied the occurrence of ANS an HIV-infected population. Methods: This was a cross-sectional study of cerebrospinal fluid (CSF) samples collected from patients co-infected with HIV and Treponema pallidum. Social-demographic and clinical-laboratory characteristics were studied. Results: Of the 348 patients infected with HIV, 33 (9.5%) had reagent treponemic and non-treponemic tests. CSF was collected from 19 asymptomatic patients. Of these, 8 (42.1%) presented with laboratory alterations suggestive of ANS.Conclusion: Social-demographic and clinical-laboratory variables should be considered for the indication of CSF collection.

Highlights

Many human immunodeficiency virus (HIV) and syphilis co-infected patients are not diagnosed, which may evolve into asymptomatic neurosyphilis (ANS)
We conducted across-sectional study with consecutive sampling according to the following inclusion criteria: patients HIV-infected with serological treponemic and non-treponemic tests reagent for syphilis; fully asymptomatic; older than 16 years; not pregnant; with recent viral load and CD4LT count examinations; without diseases that justified liquor alterations, without neurological, ophthalmological, otological, or tertiary syphilis signs or symptoms; increase or maintenance of Venereal Disease Research Laboratory (VDRL) titers, compared to the previous syphilis exam; latent syphilis independent of previous treatment for syphilis; and CD4LT count and/or VDRL serological titer
Of the 73 patients with treponemic test reagent for syphilis, 42.5% were considered cured after treatment and adequate follow-up with negative VDRL

Summary

Introduction

Many human immunodeficiency virus (HIV) and syphilis co-infected patients are not diagnosed, which may evolve into asymptomatic neurosyphilis (ANS). The aim of this study was to analyze the frequency and characteristics of ANS in an HIV-infected population, followed by an HIV/AIDS reference clinic.

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Conclusion